Provider Demographics
NPI:1043668460
Name:UNIVERSITY EXTENDED CARE,INC
Entity Type:Organization
Organization Name:UNIVERSITY EXTENDED CARE,INC
Other - Org Name:AMARA HEALTHCARE AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CONTINUING CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-774-8040
Mailing Address - Street 1:1350 WALTON WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2612
Mailing Address - Country:US
Mailing Address - Phone:706-774-8040
Mailing Address - Fax:
Practice Address - Street 1:2021 SCOTT RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-2539
Practice Address - Country:US
Practice Address - Phone:706-793-1057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY EXTENDED CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-26
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility